Noel Grealish (Galway West, Independent) | Oireachtas source

I move:

That Dáil Éireann: acknowledges that:

— the Programme for Government: Our Shared Future includes a commitment to introduce a statutory scheme to support people to live in their own homes by providing them with access to high-quality regulated home care, but this is not happening;

— the Health Service Executive (HSE) Home Support Service (formerly called the Home Help Service or Home Care Package Scheme) aims to support older people to remain in their own homes for as long as possible, and to support informal carers;

— the HSE Home Support Service aims to also support people with a disability who need home help;

— the Home Support Service is available to people aged 65 or over who may need support to continue living at home or to return home following a hospital stay;

— according to the Central Statistics Office (CSO) estimates, the current population of people aged 65 years and older will have increased by more than 30 per cent by the year 2031, and will have doubled by the year 2051;

— according to the CSO forecasts, the Old Age Dependency Ratio, the population aged 65 years and over as a percentage of the population aged 15-64 years, will continue to rise steadily in the coming years, from 23 per cent now to 41 per cent in 2051;

— more than a quarter of all people aged 65 years and older live alone;

— "Tender 2023" needs to be finalised as quickly as possible to help improve care for older people who want to remain living in their own homes; and

— reforms to social welfare means assessment could facilitate an older person having company in their home by renting out a room with a maximum income disregard of €269.23 a week (€14,000 per year) if the medical card means assessment reflected this change;

recognises that:

— the chronic shortage of home help hours means that there is a delay in discharging people from hospital, especially vulnerable older people, with the lack of home help support adding to the chaos in some hospitals in provincial locations;

— a shortage of people to work in the sector is at least in part due to poorer pay and conditions in the private sector, coupled with the fact that they do not have access to a supplementary pension; and the number of staff moving to jobs within the HSE is exacerbating the situation;

— almost 300,000 people currently provide unpaid care to others, 86,000 of whom provide such care for 43 hours or more each week according to Census statistics;

— there were 6,432 people on the waiting list for home support care at the end of March 2023, including new clients approved to receive home support care and existing clients for whom additional home support hours have been sanctioned;

— carers need regular breaks from their duties through respite care to protect their own physical and mental health; and

— the Government, through the Minister of State at the Department of Health, has endorsed the 16 recommendations contained in the cross-departmental Report of the Strategic Workforce Advisory Group to address the challenges in front-line carer roles in the home support and long-term residential care sectors; however, only one of these recommendations has been implemented to date; and

calls on the Government to:

— place home support on a statutory footing so that it is enshrined in legislation as a sector;

— provide an update on the recent tender process for home care providers;

— develop a nationwide cluster housing model for older people, with security of tenure and rent fixed to increases in the State pension;

— support not-for-profit home share initiatives that assist with the pairing of older people to suitable younger tenants;

— establish the delivery of "meals on wheels" on a national basis to enhance the health of older people, especially those living alone;

— take steps to increase the use of new technologies to assist with the care of older people, such as voice recognition software, remote health monitoring etc;

— amend the rules governing eligibility for Jobseeker's Allowance so that the total amount of paid work in hours is taken into account, rather than days, as the current system disincentivises engagement in part-time employment;

— increase the means test limits for the Carer's Allowance and establish a high-level group to scope out and develop a roadmap for the delivery of a non-means tested participation income for family carers;

— increase the financial threshold for people on State benefits so that they can work and earn more money working in the homecare sector, and this helps with staff shortages, while at the same time helping people earn more and have a better standard of living without being penalised by the State;

— allow families access to direct funding to source help/care outside regular hours rather than being restricted to private providers;

— ensure that all training for people engaging in the care industry is paid for by the Department of Further and Higher Education, Research, Innovation and Science to assist private providers in replacing staff who have moved to jobs within the HSE;

— establish on a statutory footing the principle of every family carer being entitled to a minimum number of days respite care in the year;

— ensure that remuneration for time spent travelling, motor travel expenses and pay when clients are in hospital is standardised for all healthcare employees; and

— ensure that industry and public sector travel expenses be made available for home care providers who provide home care for older and vulnerable people in rural areas, to help create a balance between rural and urban travel services.

There is a growing crisis in Ireland today that is affecting families the length and breadth of the country.

10 o’clock

The difficulty in accessing home support for older people is, after housing, one of the biggest issues coming into my constituency office every week. It is a problem that is causing enormous stress for families. This is the basis for the motion that I and my colleagues in the Regional Group have put before the House.

There are huge waiting lists for home care packages. The most recent information available from the HSE shows that at the end of March 2023, more than 6,400 people were on the waiting list for new or additional home support care. These are often extremely vulnerable people whose need for home care has been proven, and accepted by the HSE. All Members have come across cases where older people have had a spell in hospital and are ready for discharge but cannot leave because supports are not in place for their subsequent care. Late last month, 84 people on the HSE national delayed transfer of care list had their home as their discharge destination. A further 240 people were being kept in hospital while waiting for residential care to be put in place. That is 240 people in hospital, taking up beds.

Unless matters change, the whole situation regarding care of older people will continue to worsen. The census last year found there were 776,000 people aged 65 or older, an increase of more than one fifth on the position in 2016. The number of elderly people aged 80 or older will quadruple in the next three decades, to more than 500,000.

Today, there is a challenge facing thousands of families across the country which needs to be addressed with urgency. The number of officially recorded unpaid carers increased by 53% between the two most recent censuses, rising to almost 300,000 last year. Almost 87,000 of them were providing at least 43 hours of care a week, more than double the figure in 2016.

Last year, a cross-party advisory group was established to figure out how to tackle the shortage of care workers for home support services in the nursing home sector. The group came up with 16 key recommendations it believed could at least alleviate some of the problems but, so far, only one of those recommendations has been implemented. It involved allowing non-EU home support workers to be employed in home support services. Of the 1,000 work permits permitted, however, only 84 have taken up the opportunity. The reason there is so little interest needs to be further examined.

Many of the other recommendations of that strategic workforce advisory group are included in the motion which I and my colleagues in the Regional Group have put before the House. We strongly believe several steps need to be urgently taken to tackle the problem of a shortage of staff to provide the home care that thousands of people on the waiting list need if they are to continue to live in their homes and communities. Among the actions we are proposing is that home support workers be paid for time travelling between clients and that other expenses be refunded.

The motion also calls for an increase in the means-test limits for carer's allowance and a review of the rules governing the payment of jobseeker's benefit for people caring for loved ones in their family. Currently, any number of hours worked outside the home while not on caring duties is counted as a full day worked. The rules as they stand state that a person is paid jobseeker's benefit for the days not worked but if the person works more than three days, he or she gets nothing. If the rules were changed, at least for those in caring roles, to allow a certain number of hours' work per week, it would facilitate carers supplementing their incomes.

Too many people caring for members of their families rarely get a break. The motion provides for the laying down in law of the principle that every carer is entitled to a minimum number of weeks of respite care each year.

I call on the Government to support the motion. I thank Maria Burke, Teresa Delaney and Brendan Carroll in my office for their research on this issue and Cáit Nic Amhlaoibh, our party administrator, for putting the motion together.

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